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Anabolic Steroid Abuse

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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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What are anabolic steroids?

Performance-enhancing drugs are no longer just for bodybuilders or pro athletes who are willing to try illegal and potentially dangerous means to improve their body's function. These drugs are being used every day by people of all ages, from middle-school, high-school, and college students to older recreational athletes.

Anabolic steroids are one type of performance-enhancing drug. They mimic testosterone in the body to enhance performance by making muscle cells larger and by allowing the body to recover more quickly from the stress of exercise. Slang for anabolic steroids is "roids."

There are two types of steroids that are naturally produced in the body:

Catabolic steroids or glucocorticoids are part of the body's response to stress. The word catabolic comes from the Greek word meaning to "throw down," and these steroids help break down large chemicals into smaller ones. For example, cortisol helps glycogen, a large molecule that is stored in the liver, metabolize into glucose, a small molecule that can be used for energy by the body. Cortisol is manufactured in the adrenal glands and is required for many of the basic functions of the body, including glucose metabolism, the immune response to infection, and protein, fat, and carbohydrate metabolism. Prednisone, hydrocortisone, and dexamethasone are examples of steroids that are used to treat a range of illnesses from asthma and COPD to rheumatoid arthritis and allergic reactions.

Anabolic androgenic steroids are steroids that mimic testosterone in the body. Anabolic refers to the properties of these drugs to increase production of proteins that act as building blocks for muscle cells, bone, and other tissues within the body. The androgenic response (andro=male + genic=formation) describes the increased male features (secondary sexual characteristics) that occur as a result of androgenic steroids, including facial, body, and pubic hair, deepened voice, and increased sex drive or libido. The few medical indications for prescribing these medications are due to a lack of testosterone production in the body, either because of inborn errors of metabolism or because of illnesses that decrease production. Some physicians believe that decreased testosterone that occurs normally with aging is an indication for replacement therapy with anabolic steroids, but their use in otherwise healthy older patients is still controversial because of the potential serious side effects.

There are many anabolic steroids that have been manufactured over the past decades. The goal of the manufacturing chemists is to promote the anabolic effect of the drug while decreasing the androgenic effects that are most often associated with potential side effects that can be life-threatening. Examples of anabolic steroids include the following:

• Testosterone



• Androstenedione



• Stanozolol



• Durabolin



• Dianabol



• Nandrolone